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FROM September 26th, 2020

The biggest misconception about contraception in Nigeria is that contraceptives encourage promiscuity. The fact is, the education and economic empowerment of women directly correlates to their ability to plan, manage and thrive throughout their experience in the reproductive process.

So today on World Contraception Day 2020, I am leading the Wellbeing Foundation Africa in joining the WHO Department of Sexual and Reproductive Health and Research (including the United Nations Development Programme, the United Nations Family Planning association, UNICEF, the World Health Organisation and the World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) along with organizations and individuals worldwide in celebrating this important event.

Contraceptive information and services are fundamental to the health and human rights for everyone. Access to safe, quality, affordable contraceptive information and services, together with the provision of fertility care, allows people to decide whether and when to have children, and also the number of children they would like. Ensuring access to preferred contraceptive methods for women and couples is essential to securing their well-being and autonomy, while supporting the health and development of communities.
My decades of work to improve maternal health contributes to the rise of women because in Nigeria, first and foremost there is a critical need for mothers to plan their families, and survive childbirth in order to allow them to thrive. That is the ethos that drives my work as UNFPA Nigeria’s Family Planning Champion, as a co-author of the Lancet Maternal Health Series on stillbirth, as a commitment maker to FP2020 Movement and the International Conference on Population and Development ICPD25, and as a lifelong advocate for women’s rights to contraceptives and family planning.

In November 2016, the 4th Nigeria Family Planning Conference in Abuja hosted the Africa regional launch of The Lancet Maternal Health Series. National and international health leaders joined me and my Wellbeing Foundation Africa for this important gathering, including the Honourable Minister of Health Isaac Folorunso Adewole, Professor Oona Campbell, author of the 2016 Lancet Maternal Health Series and Professor Oying Rimon, The Bill and Melinda Gates Foundation, The Challenge Initiative, the Bloomberg School of Public Health,  DFID UK, USAID, Plan International, Evidence For Action, The White Ribbon Alliance and NURHI, the National Council for Women’s societies NCWS, and YWCA, among many national stakeholders.

With insights shaped by co-authoring the previous 2015 Lancet Maternal Health Series: Stillbirths: Economic And Psychosocial Consequences – and having attended the initial launch of the 2016 Series report at the global stage to coincide with the 71st UN General Assembly in that September, I observed that The Lancet Maternal Health Series covers the epidemiology of maternal health, the current landscape of maternal health care and services in both high- and low-income countries, and laid out future challenges and strategies to improve maternal wellbeing.

Addressing stakeholders alongside fellow panelists Professor Oona Campbell who launched the Series, Professor Adinma, Dr Kole Shettima, Dr Tunde Segun and Dr Allisyn Moran with the discussion entitled: “What is family planning doing for maternal health in Nigeria,” – I welcomed the Nigeria launch of the 2016 series, which provided all stakeholders and policy-makers the evidence with which to guide concrete actions to improve maternal newborn child and adolescent health services.

The launch of the 2016 report coincided with the revised WHO guidelines which recommend that pregnant women in low and middle income regions receive eight antenatal visits, and increased recommendation from the four antenatal visits previously indicated within the WHO’s focused Antenatal Care policy. It vindicated and validated the Wellbeing Foundation Africa’s MamaCare Antenatal And Postnatal Skills And Drills Curriculum model for midwives and mothers, respectively.  It demonstrated that the provision of a midwifery-led continuum of care and counsel, along with universal access to high quality affordable health services through community health insurance, improved training in emergency obstetric and newborn care, underpinned by integrating its robust patient-custody health records with digital facility health records and civil registrations data skill-sets are, together, crucial to improving survival and wellbeing.
As Nigeria’s first civil society community midwives health visitor program, the Wellbeing Foundation Africa’s MamaCare360 Antenatal and Postnatal Education Classes incorporate a postnatal session where breastfeeding techniques are delivered to mothers along with informed family planning advice. We affirm that access to family planning information and contraception is a fundamental human right, empower women to decide when and where to have a child, and how many children they wish to bear according to their circumstances, and recognising those rights, we recommend that mothers space their childbirth by 1000 days to better sustain the health and socio-economic wellbeing of mother, child and family.

In 2016, Nigeria had cause to celebrate the then-recorded 40% improved survival rates delivered over four years through Nigeria’s Midwives Service Scheme, despite government challenges in sustaining state and local government traction on these gains – which are sorely threatened today. That’s because Nigeria has once again, in 2020, overtaken India as the worlds capital of multi-dimensional poverty, malnutrition, and under-5 mortality.

Prior to the interrupted access to routine family planning services caused by the coronavirus pandemic, most low- and middle-income countries were on course to experience substantial economic growth, which will increase their fiscal space for health investments in maternal and newborn health. However, with the expected surge in ‘lockdown pregnancies’ we must ready ourselves to harmonise and standardise the wide variations within quality of care, between two broad scenarios which reflect the landscape of poor maternal health care – the absence of timely access to care (defined as ‘too little, too late’) and over-medicalisation of normal antenatal, intrapartum, and postnatal care (defined as ‘too much, too soon’) – and the submerged social determinant factors of economic distress, and co-related domestic and gender-based violence.

Yet we know the steps to take to recapture early successes:
  • The National Task-shifting Policy: When community health workers were allowed to administer injectable contraceptives, the uptake of family planning in hard-to-reach areas went up dramatically. That success was irrefutably demonstrated in Nigeria.
  • It will be hugely beneficial to improve clarity on Nigeria’s currently confusing ‘dual-qualification nurse-midwife’ overlap, to provide clear distinctions between the midwifery qualification, and the general nursing qualification, applying the learning from the WHO Midwives Voices Midwives Realities Report, which documents the voices and realities of 2,470 midwifery personnel in 93 countries and describes, from their perspective, the barriers they experience to providing quality, respectful care for women, newborns and their families.
I urge our Federal Government and policy makers to consider:
  • Integrating the International Confederation of Midwives’ Midwifery Services Framework into Nigeria’s public health policy as the best practice model to strengthen midwifery services to deliver the full complement of maternal and newborn care, including family planning.
  • To honor their FP2020 commitments to improving family planning funding and services
  • To partner with donors and other non-governmental organizations to increase financing for family planning at all levels
  • To strengthen primary health care facilities to provide family planning counseling and services for increased access and improved coverage
  • To partner with non- governmental agencies and development partners to build the capacities of healthcare providers across all cadres to encourage task shifting/sharing to overcome human resource constraints
  • To strengthen country’s forecasting capacities and supply of family planning capacities
  • To adopt innovative approaches such as community-based family planning services, involvement of men, traditional and religious leaders as family planning champions to break religious-cultural barriers
  • To continuously create awareness on family planning for women and families to make informed decisions on birth spacing.
  • To scale up deployment of patient custody health records and facility and health-worker driven digital records databases to provide real-time transparent and accountable community audit mechanisms in measuring public health services delivery

Poverty, inequality, and geographical barriers all clearly play out in maternal health where both our challenges and opportunities abound.

We should, therefore, guarantee that every woman, everywhere has access to quality care. An essential part of advancing maternal health in Nigeria is accelerating, reinforcing and replenishing the progress of family planning education and services to all women, thus preventing unwanted pregnancy. It is true that women, families and communities need births to grow, yet it is unethical and simply unacceptable to encourage women to give birth in places with low facility capability, with unskilled providers, or where the content of care is not evidence-based. This failing should be remedied as a matter of priority.

To achieve the 2030 SDG global target of a maternal mortality ratio of less than 70 per 100,000 live births, we must prioritise quality maternal health services that respond to local needs; promote equity through universal coverage of quality maternal health services; improve the health workforce and facility capability; guarantee sustainable financing for maternal and perinatal health; and generate better evidence, advocacy, and accountability for progress.
The Wellbeing Foundation Africa’s Mamacare+Nutrition program which sub-implements the Nutrition International and UNFPA NLift Strategy though the Wellbeing Foundation Africa MamaCare Community Midwifery Program, improves maternal education, family planning and nutrition through iron and folic acid supplementation, supported by Global Affairs Canada, currently reaching 11,000 women at 60 Health Facilities and their surrounding households and Ward Development Committees in the Federal Capital Territory, Abuja.

FROM September 18th, 2020

The numbers are stark:

Women make up 70% of the global health workforce, but only 25% of global health leadership. That is primarily because midwives and nurses make up nearly 50% of the entire global health workforce, and midwives and nurses are over 90% women. Yet only 13% of CEOs in the global healthcare workforce are women. It is said that unlike other sectors, healthcare does not have a “woman problem,” rather, it has a “women in leadership” problem. 

At the same time, there is a global shortage of health workers, in particular nurses and midwives, who represent more than 50% of the current shortage in health workers. And as Africa’s most populous country, Nigeria has one of the largest stocks of human resources to employ in healthcare, but it does not have enough people—women or men—working in the healthcare sector to support its population. At 1.95 per 1,000 people, Nigeria’s density of nurses, midwives and doctors is too low to deliver essential health services, which ultimately contributes to the abysmal state of its healthcare system. With the impact of coronavirus bringing global health systems to a halt, the prolonged lack of investment and systemic issues in Nigeria have compounded its vulnerabilities. This scenario makes the African continent susceptible to becoming the new epicentre of the disease.

To increase the number of health workers in Nigeria and improve on the number of women in positions of leadership in healthcare, we must build a progressive pipeline of confident girls, and support systems to remunerate healthcare workers properly, and build resilient healthcare systems in Nigeria. 

One way I’m working on supporting confident girls is through my organisation Wellbeing for Women Africa, which amplifies the voices of young African girls, by paying a global network of Youth Partners (currently we have 63 YPs from 18 countries) microgrants to write about their perspectives on the most pressing social issues of our time. For instance one YP recently released a study called Wa Wimbi, which demonstrated evidence that regardless of the sector, women continue to face discrimination and they are unable to progress due to gender barriers. The organisation aims to give young women a platform and in that way, a seat at the decision making table to ultimately allow them control over their own future. Because we know that girls’ learned lack of confidence is a barrier to their success later in life, ensuring that girls understand that their voice is important, their viewpoints are valid and that their perspective is not just interesting but worthy of remuneration, is one small way in which we can build a pipeline of women leaders.

At the same time, there is an endless need for leaders in the public and private sectors to come together to figure out solutions for better recognition, regulation, respect and remuneration for health care workers in Nigeria in the interest of building that pipeline of healthcare workers in the country. My advocacy on this issue goes from strength to strength as Inaugural Goodwill Ambassador for the International Confederation of Midwives, to my membership of the Concordia Leadership Council, and it’s not an issue that is easily solvable or that can be explained with pithy phrases. It’s going to take international collaboration and years of governmental support to create a resilient system that can hold up over generations. One successful approach to increasing the number of midwives in our country was the Midwifery Service Scheme, established with the help of my Wellbeing Foundation Africa, which mobilizes unemployed and retired but able midwives and newly qualified graduates from Nigerian Schools of Midwifery to rural communities for one year of community service. As I recently noted, best practices identified under the scheme need to be reactivated and consolidated nationally.

Within the Wellbeing Foundation Africa, we have seen, recorded and measured the value and sustained impact of placing a highly skilled midwifery workforce at the front, centre and heart of our communities-focused cradle-to-age programming, as coaches, educators, interlocutors, advocates and leaders, as the delivery centrifuge of our unique yet seemingly simple MamaCare Antenatal and Postnatal, SRHR, Nutrition, SGBV PSHE and WASH programs – and the results are crystal clear. Activating, actioning and tracking accurate information regularly through respectful and compassionate compassionate multi-directional conversations engender transformational social behavioural change and trusted learning, which together with deploying data for good, embeds key resilience into our community of best practice, improving the quality of care and lives.

The fact remains that we must attract, employ, retain, remunerate and support healthcare workers by giving a powerful leadership path incentive: healthcare in Nigeria must be made a good career choice. A recent Institute of Economic Affairs report makes the case that Nigeria could do more to partner with high-income countries to secure investment, and do more to attract global investors and international financial institutions to finance their healthcare systems. For healthcare workers to want to stay in Nigeria, they must be supported by better working conditions, training, equipment, and insurance related to workplace risks, and remuneration. 

Another way I’m working on this is by ensuring healthcare workers are properly trained. My Emergency Obstetric and Newborn Care Training Programme, or EmONC, is a ground-breaking partnership between the Wellbeing Foundation Africa, Johnson & Johnson and the Centre for Maternal and Newborn Health (CMNH) at Liverpool School of Tropical Medicine. The partnership focuses on EmONC training in healthcare facilities to improve health outcomes for mothers and their newborns, and it has seen 80% of all maternal deaths result from five complications which can be readily treated by qualified and trained health professionals. EmONC training is so successful because it takes place in-house and equips doctors, nurses and midwives, as a collective team, with the skills needed to overcome these obstetric emergencies, in an accelerated knowledge pathway from research bench to bedsides at the multi-tiered facilities most in need. The results again are clear, the state in which we have pioneered this training and achieved program saturation has the enviable status of the lowest preventable maternal and child deaths in the nation, informing my advocacy insistence of a push into the national health strategy, at scale.

At the same time, the Institute of Economic Affairs’ report states that “African countries spend more on paying interests on external debts rather than on public healthcare.” It’s a fact that needs to change, and it can change only by way of leadership from the state and local governments, by ensuring our systems can properly fixate systems underpinned by rightly targeted budgetary planning and fiscal appropriations that invest public funds equitably back into the health of our own people to deliver accessible, affordable health care.

FROM September 15th, 2020

I am deeply concerned by the recent findings that Nigeria has overtaken India as the world capital for under-five deaths, according to the UNICEF report ‘Levels and Trends in Child Mortality,’ particularly as we had previously seen significant improvements in Nigeria between 1990 and 2015. This distressing news comes just as we congregate virtually this year for the United Nations General Assembly.

The report compiles data spanning three decades from 1990 to 2019, and it reveals that 49% of all under-five deaths in 2019 occurred in just five countries: Nigeria, India, Pakistan, the Democratic Republic of Congo and Ethiopia. It finds that Nigeria and India alone account for almost a third of the deaths, and what is evermore worrying is that it is clear that there is a strong potential of a continued mortality crisis in 2020 with the additional strain of the coronavirus pandemic.

I have always felt that if the nation is truly committed to the daily goal of ensuring that our women can give birth safely to babies that can survive and thrive from the cradle to age, we must strengthen and build resilience in our frontline health care services. 

Our primary health care services must be supported beyond bricks and mortar to encompass the full range of quality affordable health care provided by a well equipped, well skilled and adequately remunerated health workforce, who are motivated to deliver respectful maternity and child health care and advice. We must intensify our efforts to engender, enable, empower, replenish and reinforce the capacities of the most appropriate and qualified health professionals to stand with women and their families as a central core focus which will be validated, vindicated and reinforced throughout this Year And Decade of the Midwife and Nurse. We must build resilience within our healthcare system.

In my opinion the significant 35% aggregated gains and improvement in maternal and child survival measured between 2010 and 2015 across Nigeria, which is now gravely threatened, was catalysed by the roll-out of the simple yet revolutionary Midwives Service Scheme (MSS), launched in 2009 by the National Primary Health Care Development Agency (NPHCDA), in 2009 during the administration of late President Umaru Yar Adua. It aimed to address the challenge of Nigeria’s very poor record regarding maternal and child health outcomes. An estimated 53,000 women and 250,000 newborns were dying annually mostly as a result of preventable causes.

The NPHCDA was tasked with establishing the MSS as a public sector initiative and a collaborative effort between the three tiers of government in Nigeria. A memorandum of understanding between the Federal, State and Local governments set out clearly defined shared roles and responsibilities, which were supported by the Wellbeing Foundation Africa and other strategic partners. The MOU was signed by all 36 states of Nigeria and was designed to mobilise newly qualified, unemployed and retired midwives for deployment to selected primary health care facilities in rural communities and facilitate an increase in the coverage of Skilled Birth Attendance (SBA) to reduce maternal, newborn and child mortality.

The MSS Technical Working Group (TWG) met regularly to receive updates, review progress and advice in order to provide strategic direction, support and guidance for the implementation of the MSS. The secretariat of the MSS was responsible for day-to-day management, whilst state focal persons served as contact people for the midwives in the MSS.

The MSS was based on a cluster model in which four selected primary healthcare facilities with the facility to provide Basic Essential Obstetric Care (BEOC) were clustered around a General Hospital with capacity to provide Comprehensive Emergency Obstetric Care (CEOC). Qualified professional midwives were deployed to each selected PHC, ensuring 24 hour provision of MNCH services and access to skilled attendance at all births to reduce maternal, newborn and child mortality and morbidity. The MSS pilot then covered 163 clusters, which had 652 PHCs and 163 general hospitals. The MSS strengthened the PHC system by distributing basic equipment (midwifery kits, BP apparatus etc, and a comprehensive civil registrations and vital statistics data capture system including partographs, to all facilities, in the form of the IMNCH Personal Health Records and Home-Based Records, developed by the Wellbeing Foundation Africa) to 652 facilities through the vaccine logistics system. The MSS was successful in establishing and reactivating ward development committees WDC’s at all MSS PHCs to ensure community participation and ownership in its implementation.

The outcomes were impressive and immediately impactful: 2,488 midwives were successful in applying to the MSS and were deployed to PHC facilities. The midwives from all over Nigeria were then given an orientation which I was pleased to host, as a member of the Critical Core Committee of the FMOH to upskill and familiarise them with the scheme. As of July 2010, 2,622 midwives had been deployed to PHC facilities in rural areas. MSS provided capacity building by the creation of a training framework, which was aimed at improving the skills and proficiency of midwives in provision of quality maternal and child health services. The midwives then underwent competency training through Principals of Schools of Midwifery. The MSS planned to implement information and communications technologies support to improve communication and articulated a monitoring and evaluation framework for the scheme. 

Partners, including the Wellbeing Foundation Africa, committed to initiating and implementing a two-pronged approach to programme communication: it focused on political leaders and decision makers, as well as clients, through radio, TV, billboards, community outreach, and health centre branding to ignite social and behavioural change and demand creation for health-seeking and health providing orientation.

The MSS faced (and still faces) five key challenges, namely: 1) implementation of the Memorandum of Understanding, 2) availability of qualified midwives, 3) retention of midwives, 4) capacity building of midwifes and 5) sustenance of linkages. There needs to be more support and commitment from officers in relevant government departments, which can be achieved by ensuring clarity on the objectives and aim of the MSS.

Over the years, several initiatives and programmes had been introduced to reduce mortality among mothers and children in Nigeria. Despite these efforts, poor maternal and child health indices had continued to be one of the most serious development challenges facing the country. Significant progress was accomplished in the implementation of the MSS initiative however and the best practices identified under scheme need to be reactivated and consolidated nationally, with a view to overcome challenges.

Despite the dire recent national indices, which were not entirely unexpected given the stoppage of the original MSS and its replacement with an eponymous but less focused model, I remain encouraged to redouble my institutional efforts for maternal and child survival. I am encouraged by the fact that Kwara and Lagos States, where my Wellbeing Foundation Africa has achieved and maintains significant programmatic scale, are now consistently recorded as having the two lowest preventable mortality rates in Nigeria respectively, while Kaduna State and the FCT Abuja where we also work have shown significant improvements. These gains highlight the importance of the WBFA’s midwifery-led direct frontline action models which deliver our MamaCare Maternity Education, EmONC Healthworker Training, WASH for Wellbeing and Hygiene in Health Facilities, Child and Adolescent PSHE WASH In Schools, and Alive&Thrive Maternal Infant and Young Child Feeding and Nutrition programs.  In tandem, we support strong accountability frameworks that can hold governments to account on their health commitments to drive a policy continuum of health for all.

Mindful of the fact that we have only ten years to accelerate actions towards our 2030 Sustainable Development Goals, the Wellbeing Foundation Africa is energised by the WHO and multi-lateral agencies’ commitments to pursuing stronger collaborations for better health. In addition, we commit to strengthening deliberate sexual and reproductive health and gender programming and women’s leadership, with the simple premise that stronger collaborations contribute to better health. This Global Action Plan for healthy lives and wellbeing for all, will promote, engage, accelerate, align and account for purposeful, systematic, transparent and accountable primary health care. It will create sustainable financing for health, community and civil society engagement, improve determinants of health, invest in innovative programming in fragile and vulnerable settings and for disease outbreak responses as well as research and development, innovation and access, data and digital health. 

In promoting better leadership at global, regional and country levels, stronger collaboration is the path, but better health is the destination.

If the nation cares to ensure women can give birth safely to babies that survive from the cradle to age, we MUST strengthen frontline health care services, immunisations, nutrition and WASH – I hope that the community of best practice we have developed and implemented towards healthy lives and wellbeing for all, from birth to age may cascade its impact across my nation Nigeria, Africa, and the world.

FROM September 11th, 2020

This week, my Wellbeing Foundation Africa’s partners at Amref Health Africa led an excellent session – “A Health Accountability Framework, Holding Governments Accountable for their Health Commitments” . I warmly welcomed the discussion of the importance of supporting strong accountability frameworks, such as the Right to Health Index, that can hold governments to account on their health commitments.

The Right To Health Index is grounded in the recognition that health accountability needs to move away from using general statistics and focus instead on identifying specific indicators for use in human rights. In doing so, accountability frameworks can facilitate the realization of health as a human right and universal health coverage for all.

Health as a human right has always been central to The Wellbeing Foundation Africa’s work, particularly the infusion of poverty alleviation, rights and gender-based programming into the WBFA’s Alaafia Universal Health Coverage Scheme Fund in partnership with the PharmAccess Foundation and Hygeia Community Health Plan.

 

The Fund, supported the Kwara State Health Insurance Scheme established since 2007 by advocating for the 2012 and 2017 enabling state health insurance legislation, and by directly providing yearly capacitation fees for 5000 pregnant and newly delivered women, as well as adolescents, people living with HIV/AIDS, and elderly beneficiaries annually, within it’s over 100,000 enrollees from 2015 onwards.

Certainly, this availability of quality affordable care has contributed in no small measure to Kwara State maintaining its status as the state with the lowest maternal and under-5 mortality in Nigeria, at a time when the nation has been confronted with the unfortunate fact of having overtaken India as having the highest and worst preventable deaths of mothers and their young children globally – underscoring the importance of sustaining focused efforts across all 36 states of the federation to arrest this devastating trend of neglect.

 

 

H.E. Senator Dr Abubakar Bukola Saraki, MBBS, CON, 13th President of the Senate and Chair, 8th Session National Assembly, Federal Republic of Nigeria, Former Kwara State Governor and Chair, Nigeria Governors Forum, at the Scale Up Ceremony of Kwara Community Health Insurance Scheme, Afon, Kwara State, 2009

I was also delighted to learn this week that the health insurance scheme has been recently re-launched with a target of 10,000 more mandatory enrollees. I heartily commend the PharmAccess Foundation and other partners for their focused tenacity in ensuring that the exemplary health insurance-driven universal health coverage model that all partners worked so hard to create and innovate, driven by the mutual vision of H.E Dr Abubakar Bukola Saraki  and the late acclaimed global health expert and medical research scientist Joep Lange to render affordable quality health care for all will continue to support and benefit many more people into the future.

Wellbeing Foundation Africa, Hygeia Community Health Plan, Pharmaccess Foundation, World Bank Nigeria, Federal Ministry of Health at Alaafia Universal Health Care Scheme Fund Conclusion Breakfast Meeting, Abuja, Nigeria, January 2017

FROM September 2nd, 2020

Road safety in Nigeria is both a global health issue and a matter calling for focused national concern: road traffic accidents are the leading cause of death in adolescents in Nigeria. More broadly, there has been an upsurge in the proportion of traffic fatalities witnessed in a number of developing countries while developed nations are witnessing downward trends. 

That is why I welcome the United Nations General Assembly and member states in passing an historic resolution endorsing the “Stockholm Declaration”, aiming to improve and save lives on the world’s roads, today.

Nigeria has the second largest road network in Africa, and our latest figures show that Nigeria is among the top 50 countries with the highest road traffic deaths. According to the NRSS, population-road ratio was estimated to be 860 persons per kilometre roadway while vehicular density stood at about 39 vehicles per kilometre roadway. Nigeria recorded 337,301 road traffic crashes from 1990 to 2012, out of which 28.6% were fatal, 44.7% were serious, and 26.7% were minor. The overwhelming majority of road traffic deaths and serious injuries are preventable and, despite some improvements, they remain a major public health and development problem that has broad social and economic consequences which, if unaddressed, may affect progress towards the achievement of the Sustainable Development Goals (SDGs). 

While each country has primary responsibility for its own economic and social development, the role of national policies, priorities and development strategies cannot be overemphasized in the context of reaching the SDGs. At the same time, international public finance plays an important role in complementing the efforts of countries to mobilize public resources, especially in the poorest and most vulnerable countries with limited domestic resources.

I acknowledge the work of the UN system, in particular the leadership of the World Health Organization, in close cooperation with the UN regional commissions, in establishing, implementing and monitoring various aspects of the Global Plan for the Decade of Action for Road Safety 2011–2020. I recognize the commitment of the United Nations Human Settlements Programme (UN-Habitat), the United Nations Environment Programme, the United Nations Children’s Fund and the International Labour Organization, among other entities, to supporting those efforts as well as that of the World Bank and regional development banks to implement road safety projects and programmes, in particular in developing countrie. 

I hope that this historic resolution will encourage all Member States to promote multi-stakeholder partnerships. I point to my Wellbeing Foundation Africa’s anatomical simulation training techniques that aim to improve health workers’ skills to address the safety of vulnerable road users, the delivery of emergency care and first aid to victims of road traffic accidents. Notably, this must happen more aggressively in developing and least developed countries, and we must provide road traffic crash victims and their families with universal access to health care in the pre-hospital, hospital, post-hospital and rehabilitation and reintegration phases. In addition, I will do my part to raise funds to bring in the right equipment for road accident trauma training.

I must particularly commend the leading role of Oman and the Russian Federation in drawing the attention of the international community to the global road safety crisis. And, I must congratulate the Member States that have taken a leadership role by adopting comprehensive legislation on key risk factors, including the non-use of seat belts, child restraints and helmets, the drinking of alcohol and driving, and speeding, and drawing attention to other risk factors, such as low visibility, medical conditions and medicines that affect safe driving, fatigue and the use of narcotic drugs and psychotropic and psychoactive substances, mobile phones and other electronic and texting devices.

With the lessons learned from the Decade of Action for Road Safety 2011–2020, the Global Development Community recognises the need to promote an integrated approach to road safety such as a safe system approach and Vision Zero. We must pursue long-term and sustainable safety solutions, and strengthen national intersectoral collaboration, including engaging non-governmental organizations, civil society and academia, as well as businesses and industry, which contribute to and influence the social and economic development of countries. I hope that state and non-state actors and policy makers will commit to prevent road traffic injuries, while I appreciate the WHO and its Director-General, Dr Tedros Ghebreyesus for its role in implementing the mandate conferred upon it by the General Assembly to act, in close cooperation with the UN regional commissions, as a coordinator on road safety issues within the UN system.

Providing basic conditions and services to address road safety is primarily a responsibility of governments. This is especially in view of the decisive role that legislative bodies can play in the adoption of comprehensive and effective road safety policies and laws and their implementation. However I recognize nonetheless that there is a shared responsibility to move towards a world free from road traffic fatalities and serious injuries and that addressing road safety demands multi-stakeholder collaboration among the public and private sectors, academia, professional organizations, non-governmental organizations and the media. That is why I acknowledge that increasing road safety activities and advocating increased political commitment to road safety, will require working towards setting regional and national road traffic casualty reduction targets, elaborating global road safety-related legal instruments, including international conventions and agreements, technical standards, resolutions and good practice recommendations. It also requires domesticating and servicing 59 global and regional legal instruments that provide a commonly accepted legal and technical framework for the development of international road, rail, inland water and combined transport, to strengthen Nigeria’s national road safety management capacity.

As we approach the end of this Decade of Action for Road Safety, and start on the relevant road safety target dates set out in the 2030 Agenda, Nigeria must deepen national engagement with the new 2021-2030 time frame for a reduction in road traffic deaths and injuries. To push forward in the Second Decade of Action for Road Safety, with a goal of reducing road traffic deaths and injuries by at least 50% from 2021 to 2030, I support the call upon Member States and stakeholders to continue action through 2030 on all the road safety-related targets of the SDGs, including target 3.6, in line with the pledge of the 2019 High-Level Political Forum on Sustainable Development convened under the auspices of the General Assembly. We must especially take into account the remaining decade of action to deliver the SDGs by 2030 in their entirety.

FROM August 25th, 2020

Today is the day we have set our sights on for decades. Because of years of work by health workers on the ground, with the support and collaboration of international nonprofits, national and local governments, and with the weight of the world’s attention, we are able to celebrate this momentous achievement: Africa is wild polio-free.

I am overjoyed that today, thanks to 25 years of coordination and commitment by the World Health Organization (WHO) and the World Health Organization Regional Office for Africa (WHO-AFRO), wild poliovirus no longer threatens our children and future generations of children across the African continent.

The achievement is all the more remarkable as the result of an instrumental campaign to vaccinate children in Northern Nigeria, a region that is choked by terrorist extremist rule. As of today, Africa is the fifth of six global regions to be officially declared wild poliovirus-free; with cases of the virus now found only in the eastern Mediterranean region. This milestone has been achieved through successfully scaling up and sustaining the delivery of vaccines to children in the hardest-to-reach places throughout Africa.  

My Wellbeing Foundation Africa has proudly supported the communities we work with to detect, interrupt, and eliminate the wild poliovirus, alongside our global and national partners. Our programmes give mothers access to information on the safety and importance of vaccines, and our Personal Health Records are now a necessity in order to empower them to make immunisation choices in the best interests of their children. Now, thanks to the tireless efforts of so many working to ensure polio vaccines reach the most remote corners of the world, more than 18 million children who would have faced polio paralysis in the past are walking freely towards healthy futures.

As the COVID-19 pandemic continues to disrupt health services, damage health systems and burden health workers, it is imperative that we come together globally, again, to address the public health challenges of the future. We must strengthen routine immunization programs in Nigeria, specifically to achieve full eradication of all forms of polio, including circulating vaccine-derived poliovirus, which remains prevalent in areas with weak or partial immunization coverage. To build on this enormous success, we must sustain our commitment to mass immunization campaigns, and we must do more to stop dangerous misinformation from spreading.

Today marks a truly momentous milestone. My Wellbeing Foundation Africa offers our deepest congratulations and respect to the heroic health workers, community leaders, and volunteers who have contributed to this tremendous success. Congratulations, Africa!

FROM August 11th, 2020

The lived experience of Riskiat, the blue-eyed woman from Kwara state, underscores the need for economic empowerment to also tackle unconscious bias and gender discrimination.

 

Riskiat Abdulazeez and her daughters grabbed headlines and pulled heartstrings in Kwara state last week when she spoke out with a distressing story about being abandoned by her husband and rejected by his family. The 30-year-old mother of two was left alone to afford food and education for her children, all because of a scepticism surrounding her distinctive pale blue eyes. 

When I studied Riskiat’s story, what struck me was not just the unique (and beautiful) colour of the eyes: it was the fact that her life story is that of a typical woman in Nigeria—a story that so many of the United Nations’ goals and resolutions aims to target, support and empower.  She was a girl child who had every hope, but encountered every barrier. 

Riskiat and her children
Riskiat and her children accepting the donation from the Wellbeing Foundation Africa

As a child, Riskiat went to primary and secondary school, but didn’t sit her final examinations because her parents could not pay the fees, as she explained to PUNCHNG. Instead, her parents enrolled Riskiat in an apprenticeship, and following the apprenticeship, she worked in a shop where she met her husband, Abdulwasiu, in her early 20s. 

After courting for a year, Riskiat and Abdulwasiu married, and Riskiat quickly gave birth to three children: five-year-old Kaosara and one set of twins, two-year-olds Hasanat Kehinde and Taiwo. The daughters, Kaosara and Hasanat Kehinde, inherited Riskiat’s distinct eye colour, while Taiwo, the son, had traditional brown eyes. The family lived together in Abdulwasiu’s family home, and Abdulwasiu, a vulcaniser, struggled to support the children’s diet and education, particularly as the COVID-19 pandemic brought Nigeria to a halt.

It is clear through Riskiat’s interview that Abdulwasiu’s family was distrustful of Riskiat already—but the trigger point that led to the family breakdown happened when the male twin, Taiwo, fell ill earlier this year. As Riskiat illustrates in PUNCHNG, the family could not financially support his care, and ultimately, Taiwo died from his illness. The grief and devastation eroded the family’s cohesion even further: distraught because of the loss of his son, poverty-stricken and pressured by his family’s scepticism about the fact that Riskiat and the blue-eyed daughters had survived, Abdulwasiu instructed Riskiat to move out of his parents’ home.

“He told me that his parents said they could not live with children with blue eyes. My husband also said his parents told him to marry a woman that would produce children with normal eyes,” she told PUNCHNG.

We have always known that unplanned point-of-care medical expenses can throw families into poverty, but Risikat’s story shows us the devastating effect that unavailability of medical coverage can wreak. It impacts lives negatively far beyond the original community coverage aims of health for all.

What Riskiat has yet to experience is self-sustaining autonomy via her own economic empowerment. As a child she was barred from further education because her family could not afford the fees. As a young adult, she attempted to make a living for herself, but instead married young and then struggled to feed, educate and protect her family because she relied on her husband, who could not support them. At 30, Riskiat has fire in her belly and light in her blue eyes: she insists that she does not want her husband back, and is steadfast in her interest in finding the best path forward for her children. 

“God who created us has plans for every individual. I don’t have any specific thing (planned) for her and her sister. I only wish that they would become great in future” she said to PUNCHNG.

 

 

Riskiat’s inability to control and plan her own life is the story of many women just like her, particularly in Nigeria. Country-wide, at age 20, less than 4% of men are married, compared to about 50% of women in rural areas. In some areas, around 40% of girls are married and 11% give birth all before age 15, which robs them of their educational attainment, career mobility and earning power, and makes them vulnerable to dangerous pregnancy complications like fistula. Moreover, we know that when we invest in women and girls, they invest in everyone else around them. That’s why I was not surprised to read that Risikat took a decision to sell her small patent medicines shop to raise the resources to feed her family during trying times. Women typically invest a higher proportion of their earnings in their families and communities than men. Women’s economic participation and ownership of their own finances helps overcome poverty and improves children’s nutrition, health, and school attendance. 

Reading about how Risikat lost her twin son Taiwo, due to not being able to afford the necessary medical care in Kwara State in 2020, shocked my core beliefs, advocacy and actions regarding universal health coverage. From 2007 to 2016, my Wellbeing Foundation Africa’s Alaafia Universal Health Access Fund had supported the Kwara State Government in its partnership with Hygeia and the Pharmaccess Foundation, in launching the Kwara Community Health Insurance Scheme (CHIS), providing a comprehensive package of healthcare to all indigenes, and mitigating the economic devastation of unplanned point of care expenses with a record-breaking and prize winning low capacitation fee recognised as recently as 2012, 2014 and 2015.

The Kwara State CHIS was renamed KwaraCares in late 2018, and shockingly, was inexplicably not accessed or not available to Risikat and her children in 2020 despite its strongly vociferous media presence.

So when I intervened in Riskiat’s situation with a token donation for her children’s education, it is not just because of compassion for a woman and children with striking eyes. It is because a small investment in Riskiat—allowing her basic economic empowerment, and the ability to make her own autonomous choices for her life and that of her children independently—has the potential to stop a cycle of disempowerment and negative dependency that Riskiat and so many others experience.

Alongside making the donation, I also immediately requested that the eminent Professors of Medicine at the long renowned University of Ilorin Medical Centre of Excellence and Teaching Hospital respectfully offer the family full medical screening, as the striking beauty of their blue eyes aside, it is not unusual for cases of ocular albinism to be associated with rare genetic conditions.

I made this donation and medical referral as I continue to advocate that public health and education policies must deliberately, intentionally, and accountably replenish resources. They must reinforce learning and knowledge and embrace gender-data statistical values in managing pro-poor innovations and universal health coverage, to put people first, particularly women, newborns and girls, and leave no one behind, particularly in Kwara State where the Wellbeing Foundation, stakeholders and non-governmental organisations continue to work so hard and long to deliver the lowest under-5 mortality in the land.

 

FROM July 22nd, 2020

I am overjoyed to receive a photo and update from a Wellbeing Africa Foundation mum today, and I must share the story.

In 2017, Mrs O was pregnant with triplets, and had been a student of my #Mamacare360 program. She needed, but couldn’t afford a Caesarean, and the hospital just kept her waiting. The hospital was ready to abandon them.

I have always advocated for socio-economic birth preparedness within universal health coverage, but birth waits for no-one, so I dashed there to help immediately.

That’s because a sound anti-poverty strategy should not only aim to increase incomes, but also provide the poor with a variety of assets — personal, social, political and environmental to help them overcome the myriad of challenging circumstances. ⁣

Sometimes being there for the right person, with the right help, at the right place, can change a life (or in this case, three more lives) way beyond the original aim of poverty alleviation. ⁣

Here is a photo of the absolutely beautiful triplets today: they have grown so big and strong, and it has made a sunny day today even brighter.

Triplets
The triplets, 2020

FROM July 21st, 2020

A few weeks ago, I read an absolutely harrowing story of abuse in Akwuke, near Enugu City, Nigeria, and it has been on my mind ever since. I am consumed by the fact that its graphic nature and intimate impact were entirely preventable, if only the right systems were in place.

Early in June, a wife and mother of two young boys—we will call her Mrs. K—asked her husband for money to prepare food for the family. He had a history of violence, and he lashed out about the inquiry: when she proceeded to make pap for her 3-month-old baby, he doused her breasts in boiling water. She reacted in the throes of excruciating pain, and also unable to breastfeed her baby. The Women’s Aid Collective (WACOL) posted the story on Twitter, including graphic photos that I am choosing not to continue to publicise. WACOL has confirmed that the husband is now in police custody, but the psychological, emotional and physical damage to Mrs. K and her children has been done, and it is on us to use this case as a calling to rethink how we are handling the scourge of domestic violence in Nigeria.

The story is the horrific climax of a pattern that we know to be true when it comes to domestic violence: notable triggering factors for the husband’s actions in this case are concerns about money, food, and the fact that Mrs. K was exercising her personal autonomy—through breastfeeding the baby. We know firstly that domestic violence is rising due to pressures about money amidst the pandemic; secondly, research also shows that male partners who are inclined to violence increase aggression during pregnancy and after birth, and thirdly, we know that jealousy (in this case, about feeding the baby) can be a trigger for men inclined to violence.

While the global community is aware of these factors, limited access to reporting pathways means local organisations weren’t able to shield Mrs. K before the abuse was so great that it required extreme intervention. Her case makes evident that the reporting of incidents of intimate nature, such as sexual assault and domestic violence, necessitates the transfer of Sexual Assault Referral Centres (SARC) from police stations to hospitals.

The Nigerian police force is culturally hyper-masculine and male-dominated, and Nigerians are 20 times more likely to be killed by the police than by terrorists. It is obvious that an aggressive and masculine environment in a conservative cultural setting is not a safe space for vulnerable women to share intimate stories about private parts of their body. In fact, a police station in Nigeria could be the worst place I could think of for a woman to go to seek relief. That’s why I’ve begun reaching out to call for a timely policy shift, nationally, to shift SARCs to hospitals: the hospitals would assume locus as expert witnesses, and bear the formal responsibility for reporting and advising the police on sexual and domestic violence cases. In turn, the idea is that injured women, or women in danger would feel more comfortable seeking treatment about intimate issues than in a police station. They would be treated for their ailments, and hospital staff would assume the responsibility for translating actionable items to the police. Like any crime, the prospect of swift justice, would also serve as a deterrent, and thus a very timely tool in the strategy to effect preventive social behavioural change.

This call to action is about ensuring we have the right systems in place to safeguard and ultimately empower vulnerable women with the public resources we have available. It is said that sexual and gender based violence is within the lived experience of almost half of our women and girls; equipping health personnel with specialist SGBV SARC and mental health training is both prerequisite, and an imperative.

At the Wellbeing Foundation Africa, we have long offered women attending our health facility based Mamacare antenatal and postnatal sessions a safe space, and a curriculum to discuss concerns, and if needed, report their worries. Nigeria’s updated National Gender Policy should take a whole-family, socio-economic and mental health approach to tackling the scourge of domestic violence; and one way we can start is by ensuring the safe haven of refuge, of a kind of solace: a comfortable environment for vulnerable women to give forensic evidence, find relief, and heal. We must do it for Mrs. K.

FROM July 14th, 2020

I thoroughly enjoyed kick-starting the new week by participating at the UN High-level Political Forum side event entitled, “From Page to Action: Accountability for the Furthest Left behind in COVID-19 & Beyond.” The conversation was strong, timely and direct, as well as being a fantastic way to launch the 2020 Report of the UN Secretary-General’s Independent Accountability Panel for Every Woman Every Child.

Co-hosted by the Governments of Japan, South Africa, and Georgia and co-organized by the Every Woman Every Child Secretariat, the Independent Accountability Panel (IAP), International Health Partnership for UHC 2030 (UHC2030), and the Partnership for Maternal, Newborn & Child Health (PMNCH), I appreciated the opportunity of knowledge sharing to deepen the efforts and engagement of my organisations, the Wellbeing Foundation Africa, and Wellbeing For Women Youth Voices towards promoting institutional accountability at national, regional and global policy tiers.

As we herald the new commitments targeted at mitigating the disruptions of the Sars-Cov2 pandemic in expectation of focused investments, we are once again reminded that the initiation, solution and fiscal appropriations to drive the delivery and accountability of truly accessible health for all must be embraced and fall within the remits of local and national parliaments. Today, and every day, I particularly commend the WHO Partnership for Maternal Newborn And Child Health PMNCH’s ongoing strong collaboration with the International Parliamentary Union IPU, as signalled by the Inter-Parliamentary Union’s historic first resolution towards Universal Health Coverage in 2019, substantiating global approaches to recordkeeping.

I was particularly enthused by contributions from a number of high-level speakers and leading voices for the delivery of Universal Health Coverage, namely, H.E. Mr. Cyril Ramaphosa; President of South Africa; Chairperson of the African Union, Mr. Shinichi Kitaoka; President, Japan International Cooperation Agency JICA, Ms. Joy Phumaphi, Co-Chair, Independent Accountability Panel for Every Woman Every Child, Mr. Elhadj As Sy; Chair of the Board, Kofi Annan Foundation, Ms. Gabriela Cuevas Barron, President, Inter-Parliamentary Union, Dr. Khuất Thị Hải Oanh; Civil Society Engagement Mechanism, UHC2030, Dr. Natalia Kanem, Executive Director, UNFPA, H.E. Mr. Kaha Imnadze; Permanent Representative of Georgia to the UN, H.E. Ms. María Fernanda Espinosa Garcés; Member, UHC Movement Political Advisory Panel, UHC2030, Ms. Evalin Karijo; Project Director, Youth in Action, Amref Health Africa, Mr. Peter MacDougall, Assistant Deputy Minister of Global Issues and Development, Global Affairs Canada, Dr. Tedros Adhanom Ghebreyesus; Director-General, WHO; Chair, H6 Partnership, Rt. Hon. Helen Clark, Former Prime Minister, New Zealand; Board Chair, PMNCH, and of course, Ms. Gillian Tett; Chair of the Editorial Board & Editor-at-Large (US), The Financial Times (Moderator), alongside so many EWEC partners and frontline organisations.

But as the COVID-19 pandemic’s grip on the world shows no immediate signs of loosening, organisations must therefore acclimatise effectively, by integrating the dual-mindset towards technology, in equipping their workforces and ensuring that the dissemination of information – particularly pertaining to health – remains both accurate and accessible. By making this part of an ongoing global transition a priority, we will see to it that society’s most vulnerable individuals are able to continue accessing the information and services which remain a key component in their livelihood.

As Nigeria, seeks to mitigate the regrettable and inexcusable reputational damage that recent appalling breaches in cybersecurity have caused, we must also underscore the vital role that technologically supported security platforms play in enabling for remote operations and a continued key health services to be delivered when implemented effectively. Invoking cybersecurity measures have been and continue to constitute a key component in ensuring that accurate health information is circulated worldwide, particularly during this Covid-19 pandemic. We must therefore support all initiatives and efforts in the direction of this construct remaining a top global priority.

FROM July 6th, 2020

For many years, the welcomed priority, purpose and daily-sensitised goal for Women and Girls, Families and Communities – nationally and across our continent as a whole – has been to solidly create, inform, empower and manifest a true demonstration of equality, access and social responsibility regarding their health, their education and the equitable opportunities afforded to assure and improve basic wellbeing, from birth to age.

Through the continued collaborative efforts of our nation’s healthcare professionals, researchers, thought-leaders, community volunteers and the service users themselves, Nigeria had long subscribed to the notion of investing in Universal Basic Education. However, the first time that citizens experienced the concrete benefit of an intentional basic or primary public health assistance was in 2018, when Nigeria’s 8th National Assembly appropriated the Basic Health Care Provision Fund – a pinnacle moment in the redemption of the 2001 Abuja Declaration towards achieving Universal Health Coverage. Today, that resounding national applause remains of strong resonance to the Joint Civil Society Organisations Primary Healthcare Revitalisation Support Group to the Eighth National Assembly, which I had chaired.

With that being said, a real sense of recurring readiness and receptiveness to campaigns, cultural change and the communication surrounding health and wellbeing as a whole remains palpably evident, statistically proven and collectively celebrated by many – both nationally, and worldwide, and is categorised amongst what still remains a series of promising results acquired through WBFA’s advocacy and partnership efforts with policy-makers and parliamentarians worldwide.

In addition, and perhaps more pertinently given the progression of the ongoing COVID-19 pandemic, my morale embodies the significance and importance of global partnership interventions such as that of the Global Financing Facility and the Global Citizen Fund. Their commitment to amplifying the importance of collective efforts in acquiring globally accessible health tools and resources during the pandemic, brings us all one step closer to the concept of continuity of services becoming a very possible reality.

As, the Global Financing Facility announced its predictions last week, it conveyed a new set of commitments aimed at mitigating the disruption of services to a number of the countries and global communities most in need. GFF forecasts a possible 18% increase in child mortality, and a 9% increase in maternal mortality across Nigeria over the next year as a direct result of essential health services becoming fragmented during this COVID-19 pandemic. We had only recently learnt the surprising news that Nigeria’s 9th National Assembly had predicted a reduction in the value of the primary healthcare and basic education budgets, which as unaddressed to date – reflect as cuts.

However, as 30th June marked the International Day of Parliamentarianism, I was also caused to reflect upon the OECD’s interpretations of the role of parliaments during the COVID-19 crisis.  The COVID-19 pandemic is posing threats not only to human health and life, but also to people’s socio-economic well-being and countries’ economic growth. According to the OECD, the global economy is currently suffering its deepest recession since the Great Depression in the 1930s.

One of the many visible issues of the current pandemic is the rampant unemployment and loss of income. As well as the increase in poverty, it could impede people from accessing basic services due to unaffordability and inaccessibility. It is estimated that 2.9-5.2 million people could lose their jobs in Indonesia as a result of this global health crisis. Clearly the pandemic is heightening inequality and inequity among citizens as well as within the countries themselves.

Yet, presently, the role of parliament is more relevant today than it has been ever before. Parliaments can propose and adopt necessary laws to assist their respective governments in intercepting and tackling COVID-19 and its adverse impacts. Further, parliaments can oversee the expenditure of the public funds related to COVID-19. It is crucial to ensure that the funds are allocated appropriately, and that all individuals receive fair distribution of strategically proposed COVID-19 containment measures.

In responding to the COVID-19 crisis, parliaments in Nigeria, and around the world have also established designated Task Forces for COVID-19, aiming to provide assistance and support in the form of medical equipment and personal protective equipment to hospitals and community health centres, in a globally observed and commended response. Every state has different capacities and resources to counter the challenges, whether it is providing and maintaining optimal and accessible healthcare, upholding a functioning and thriving society or managing the state of the global economic. Therefore, international co-operation is imperative, in order to ensure that states – especially within low- to middle-income countries, are able to thrive in this moment of crisis, and eliminate their obstacles in tackling COVID-19.

Not surprisingly, three weeks ago, I had joined a high-level discussion on how the ongoing COVID-19 pandemic perpetuates the pressing need to implement Universal Health Care. In welcoming the Africa Leads UHC One By One 2030 Report, and in the new Unite For Action global commitments, I fully agreed that primary health care must cover the breadth of the journey from hospital to hut in communities, and improve the social determinants of all those living and working therein.

We should not wait to improve the situation until, God forbid, the next crisis occurs. We have to ensure that our nations’ socio-economic development would not leave anyone behind, as envisaged by the 2030 Agenda. In that regard, every decision, law and regulation made must also be based on principles of equality, participation, non-discrimination, accountability and transparency.

I have urged all African Leaders to reinforce and reconfigure their commitments to the 2001 Abuja Declarations in order to exceed the minimum pledged 15% of respective Consolidated Revenue Funds, if we are indeed to fulfil our mantra’s of Africa Rising – to match these global commitments with clear manifestation of a sense and purpose, of evidenced intention, to put our people first, justifying continued global partnerships and multi-lateral assistance.

As we face the prospect of reinstating routine primary health and education services that were so destructively interrupted by the coronavirus pandemic, it is clear that Africa needs to factor in the replenishment and reinforcement of investments in both primary health care, and primary education. In doing so, they will build resilience to emerge from the pandemic in a stronger position than before. We must ensure that our weakest frontline services can deliver a healthier, better and stronger educated future for all.

As we herald the new commitments targeted at mitigating the disruptions of the Sars-Cov2 pandemic, in expectation of focused investments we are reminded then, that the initiation, solution and budgetary injection must primarily derive from the pots that sit within local parliaments, while recalling that in fact, in 2019, the Inter-Parliamentary Union did actively play its part in passing its historic first resolution towards universal health coverage, substantiating global approaches to recordkeeping.

Parliaments themselves should also intensify this co-operation and share their best practices, experiences and challenges in dealing with the COVID-19. International organisations such as the OECD and its Global Parliamentary Network have a pivotal role to play during these unprecedented times. They help to facilitate pertinent policy dialogues on important socio-economic matters and provide us with advice and recommendations, so that parliaments can use them as guidelines to improve the situation and/or propose to its governments.

To use the example of the Indonesian Parliament view that the implementation and achievement of the Sustainable Development Goals (SDGs) cannot be postponed amid the COVID-19 pandemic, I restate the fact that the SDGs should be the measure for parliaments to prevent trade-offs in this moment of crisis, for example, between the economy and health, in any laws or programmes. It is also important to emphasise that the entire Indonesian House of Representatives, including those in the commissions, are working to support the implementation and achievement of the SDGs, supporting resolutions relevant to SDGs and that are in the public interest.

This is also the time for us as Nigerians, and as Africans, to open our eyes and realise the importance of improving individuals’ social and economic rights – especially the poor and vulnerable – such as clean water and sanitation (SDG 6) and economic growth tied to decent work (SDG 8). It is clear that fighting COVID-19 requires people to have clean water and sanitation – and not everyone has access to it.

Much of our nation’s willingness to learn, embrace and engage with the plethora of ongoing initiatives that have so positively contributed to the building and delivery of timely, appropriate and affordable care concepts and pathways in Nigeria today, is arguably attributable to the overarching and consistent primary theme of ‘accessibility’ these tremendous efforts were primarily built upon. A fearlessly competent, responsible and promising generation have successfully ensured that accessibility remains a true ethos and the pertinent undercurrent when shaping and delivering an intentional and undeniably imperative standard of care. Sadly, their efforts have now rather tragically arrived at a potential point of trepidation.

These findings should fill every stakeholder with encouraging zeal, renewed passion and an inexplicable sense of determination to work towards establishing tangible, long-term solutions for this pandemic and beyond.  We must continue forward – and ensure that a path towards the sustainable replenishment of much needed resources is assured.

To date, the responses and levels of engagement from members of society coupled with repeated statistical confirmations of increased success following the introduction of a number of health and wellbeing initiatives, further echoes my sentiments and of many others. Now more than ever before, the nation requires a firm continuation of a well-functioning, culturally and economically appropriate primary health and basic education system – one which must remain accessible to all and for all, in all its entirety. With this being said then, the most poignant way of ensuring that this can and should be made possible, is to maintain the level of financial input that 9th NASS initially committed to and maintained in the lead up to this unfortunate outcome.

In light of the recent COVID-19 outbreak, and while duly and empathetically acknowledging the economical setbacks that such a global pandemic has birthed, it is with the greatest of respect, care, honour, but also pride for all that we as a nation have achieved, that I make mention of this decision being a very important one.

From our global counterparts and stakeholders, right through to a growing community of invested and daily-committed healthcare and education facilitators here in our nation of Nigeria, the transitions and great strides made and being reflected by way of national and international policy, practice and (societal) position are going from strength to strength. Many of you have responsibly embarked on a lifelong journey which has continuously proven to be of great societal, medical and generational benefit. This is particularly evident statistically.

With health, as with education, the access to upholding and maintaining it, and human engagement really do go hand in hand: the intentional attitude and efforts our nation employs daily in a bid to truly care, educate and continue advocating for a significantly positive quality of life for all, is in actual fact, entirely dependent on the resources being made available to professionals and those within their care.

Access to affordable healthcare and education then, should be a precise and continuous embodiment of the primary intention behind the service and its delivery. I believe that the truest way in which we can continue to facilitate, impact and inform attitudes and approaches to healthcare and education in our nation, in a way that evidently works well, is to truly uphold our level of (physical and financial) input. Only then, can we truly make it holistically accessible.

Last week, I signed my name to join the #GlobalGoalUnite call for urgent investments and actions.

Join me, by signing the campaign here, too: www.globalcitizen.org

 

FROM June 20th, 2020

There are more displaced peoples in Nigeria—over two million—than the populations of Ilorin, Abuja and even Benin City. The scale of this situation in Nigeria is a tragedy for our people and our economy.

At home in Nigeria, the conditions being faced by our population of concern are an increased cause for alarm and focused action within our COVID-19 response strategies – Nigeria is facing immense humanitarian and protection challenges due to the ongoing insurgency in the North East. The conflict has caused grave human rights violations, impacting particularly on the most vulnerable civilians.

According to the UNHCR, as of May 2020, there are 2,046,604 internally displaced persons in the Northeast region, with 90% of the displacements in Borno, Adamawa and Yobe states. Outside of the Northeast an estimated 578,119 people are displaced due to banditry and farmer-herders conflict. There are 61,361 registered refugees and asylum seekers as of April 2020, with 60% located in Cross Rivers, 21% in Taraba, 12% in Benue and 6% registered in Lagos whom are classified as urban refugees and asylum seekers. There are a further 292,513 Nigerian Refugees in our neighbouring countries of Niger (55%), Cameroon (40%), and Chad (5%).

View the map>>

In summary, as of May this year, the total number of people attributed to Nigeria’s existing population of concern stood at 2,107,965. More than 61,000 were registered as refugees and asylum seekers, and the significant remainder originating from neighbouring nations were identified as internally displaced persons (IDP).

The spectrum of challenges that refugees and displaced persons face is very broad: they may be traumatised, having lost homes, livelihoods and identities. However, when the host communities have strong systems in place, the suffering is mitigated, and the road to recovery can begin.

I have always felt that refugees should have health rights guaranteed in any host location, and health-enhanced certifiable identities. The United Kingdom, Greece and Turkey support the health of refugees effectively, with the help of the World Health Organisation, which works closely with government health departments to provide culturally and linguistically sensitive health services to refugees. That’s why in February I was pleased to attend the launch of the Lancet Migration, a collaboration of researchers in migration and health who are building evidence to drive policy change in this area.

I’ve been involved with helping to provide aid to many refugee camps in Northern Nigeria, and I’ve come to the understanding that ensuring health care should be standard in supporting the dignity of displaced persona.

On World Refugee Day today, I commit to working with Lancet Migration, and call for attention on the rights of refugees in relation to accessibility to health care.

FROM June 1st, 2020

This year marked the start of the United Nations’ Decade of Delivery, where we were promised that things would change for the empowerment of women and girls. Armed with research to prove how much better off our world would be with the rights of women and girls realised, we in the global advocacy community declared that it is well past time to start living in a gender equal reality.

But instead of keeping our promise to protect and empower women and girls, in Nigeria in 2020, we are still burying them.

Vera Uwaila “Uwa” Omozuwa was a 22-year-old student at the University of Benin who went to her church to read in a quiet space when she was brutally raped. The viral photos of her bludgeoned body have reverberated around the world, adding fire to the flames of the conversation about brutality, violence and lack of a framework for social justice and responsibility; she died of her injuries on 30 May.

In Lagos, 16-year-old Tina Ezekwe was trying to get on a bus when a drunken, corrupt police officer attempted to bribe the driver, leading to a sloppy confrontation and shots fired: the bullet pierced through the upper left side of her lap. The battle to save her life lasted for two days, and she died on 28 May.

In Jigawa, Jennifer, a twelve year old girl was allegedly raped by 11 men, who have been arrested.

In 2018, promising young girls Anita Akapson and Linda Angela Agwetu were murdered in similar, senseless fashion, again by trigger-happy officers around their own homes. These cases spotlight what has been blindingly evident since the forced abductions of the Chibok and Dapchi Schoolgirls: we are failing our women and girls.

Last year I was honoured to join the International Conference on Population and Development, full of hope to deepen Nigeria’s consultations on gender. I called to build political commitment from leaders and policymakers to speak out, condemning violence against women. But with the heartless, thoughtless violent deaths of Uwa and Tina it is clear that we have thus far failed to engage leaders and policymakers to implement meaningful mechanisms to protect them.

I had declared in 2018, after the death of another innocent girl victim of sexual and gender based violence, Ochanya,  that we were standing on a gender precipice from where good actions could flow, if together, we determinedly took the right actions to protect women and girls.

I declared that I envisaged a world where everyone can decide freely when to have children, and has the information, education and means to do so. With sexual and reproductive health care deemed “non-essential” during the COVID-19 pandemic, and consequent restrictions implemented all over the world, we have failed to protect women’s rights to her own body.

At the United Kingdom-France consultations on the Prevention of Sexual Violence Initiative last year, we said with such hope that we would uphold the United Nations Security Council’s Resolution 1325 on women peace and security. While at the African Women Leadership Network and the African Union with UNWomen last year, we vowed to invest in women’s groups, to ensure that we give women the leadership opportunities to better shape their own futures, and we did. But when globally, only 1% of gender equality funding is going to women’s groups, we have failed to invest in women.

At the Commonwealth of Nations last year, we made a promise of No More Violence, yet, here we are, from our leaders, and right down to our grassroots, failing women and girls. Frankly, I am outraged. The gruesome deaths of Uwa and Tina are a visceral notice of our failure in Nigeria, and that’s why I am joining the WACOL Tamar SARC and Social Intervention Advocacy Foundation to call for radical reform of our police, to end the impunity of sexual violence against women and girls. In the name of all our global and national commitments to women and girls, the Nigerian state must make systemic changes to protect our young girls. Uwa and Tina’s lives will not be lost in vain.

Join the cause>>

FROM May 29th, 2020

The recent stories about violent police killings of African Americans are pulling at my heartstrings.

My expertise is in child and maternal health and wellbeing in Africa, and police brutality in the United States may seem like it is 6,218 miles (the distance from Lagos to Minneapolis) away from my wheelhouse. But that would be denying the reality that we Africans are a global community united by the colour of our skin and ancestries that have been altered by systems of oppression that have spanned and scrambled our societies for generations, and which we have, collectively and individually, climbed to overcome.

I care for mothers and children in Nigeria and Africa because when maternal mortality is so high and when we see black people dying of COVID-19 at a far higher rate than white people, it is of existential importance to nurture the forthcoming generations of our people. As Ta-Nehisi Coates once wrote, black people love their children with a kind of obsession, because black children are endangered.

The video of George Floyd, pleading for his life from under the knee of a casual police officer; the story about the EMT nurse Breonna Taylor, shot a shocking eight times after a misunderstanding; that Ahmaud Arbery was practically hunted by mistaken neighbours while out for a jog is a stark reminder of our peoples’ endangerment.

With all of its power and functioning bureaucracies, the U.S. —held up as the pillar of democratic practice globally—has the means, the wherewithal, and the opportunity to signal to the world that it values black lives. I am given an ounce of relief in the fact that the U.S. Justice Department said it would make a federal investigation into Mr. Floyd’s death a “top priority.” However more must be done through education, investment and empowerment.

In the face of mounting police brutality in my own country, in 2019, I encouraged the youth-led END SARS Movement in Nigeria, initiated by the Social Intervention Advocacy Foundation. Their aim was to establish much-needed partnerships between the key security agencies, academia and industry practitioners for research-based solutions. They have advocated for operational and governance models to be developed—to put a stop to extrajudicial killings of young people.

Since then, some best practices have been adopted and shared, as well as SIAF joining a national security cooperation in support of peace and stability. The work continues as they liaise with national government security agencies and to facilitate them in improving operational standards and good governance, and as they help to maintain a peaceful and tranquil society.

Riots are not an answer – to enable change, stakeholders know that they must constantly undertake methodical studies of endemic and emergent problems in the principles and practices of law enforcement policing, intelligence operations, maintaining homeland security, transnational security and trafficking, corruption and the criminal justice system and promotion of science and technology. Reformation in correctional services and forensic sciences, being an integral part of the justice system, must also be researched thoroughly.

We as Africans and African diaspora must work to instil the understanding that soft phrases such as ‘race relations’ oftentimes hide the fact that racism for so many of us is corporal. The failure of health systems to protect and cure people of black and minority ethnicities around the world means that racism does manifest through organ failure via COVID-19. The failure of police hierarchies to ensure its ranks are careful, and the failure of education systems to teach its pupils about other cultures is manifested through bodies bleeding out from gunshots. Some are calling for African leaders to summon their local US ambassadors to speak out against these injustices, and in the name of our community, I join in that call. We must unite our global African community around these lost souls, who have been killed extra-judicially, to proclaim the might and meaning of human rights and social significance of our people.

FROM May 26th, 2020

As we mark Africa Day, I am encouraged by the milestones we have achieved, standing together as one united Africa, towards providing equity in health access since the Alma Ata declaration of 1978.⁣

Personally, a high point for Nigeria was in 2018 when Nigeria’s National Assembly, chaired by my husband H.E. Dr Bukola Saraki MBBS, CON, helped establish the Basic Health Care Provision Fund. It was a key and catalytic step towards achieving Universal Health Coverage for our citizens.⁣

As the coronavirus pandemic puts health systems to unprecedented tests, I call on our African leaders, of governments, of policies, and of innovative actions, to rise to the challenge of the #AfricaWeWant. We must accelerate investments and actions to meet the health needs of our citizens by strengthening primary health care services with efficient diagnostics, referrals and treatment. Let’s walk the talk for primary health care and wellbeing.⁣

As we stand together in rallying the right resources to combat COVID-19, I also call for the reinforcement and replenishment of the 2001 Abuja Declaration—a pledge made by the African Union, standing as one, promising to increase their health budget to at least 15% of the state’s annual budget. The World Health Organisation reported in 2010 that only one African country had reached that target. Today in 2020, we must replenish and reinforce those promises to ensure that every citizen can access an efficient system of quality health.

FROM May 20th, 2020

During a normal year I would be traveling to the World Health Assembly this week, but this year I joined state leaders and world-renowned experts virtually from our homes, in light of the COVID-19 pandemic. Still, the spirit is evident: global collaboration on the state of our world’s health has never in our lifetime been more necessary.

During this week’s World Health Assembly, I am calling on global leaders, particularly in Nigeria and across Africa, to make commitments to rebuild and reinforce every element of primary health care.

 

This is backed by the decades I have worked on maternal, child and family health throughout Nigeria. Primary Health Centres (PHCs) are mostly located within communities, and much of Nigeria and Africa remains rural. With the majority of Nigeria’s population living in these rural communities, and a recognition of the strong indications of community transmission of the virus, PHCs should serve as an important link in the management of the COVID-19. In 2015, I successfully facilitated a maternity referral standard primary health centre at Eruku Cottage Hospital in Kwara State, and saw the benefits of a prompt pathway from diagnostics to treatment and care.⁣

 

 

Similarly, from my leadership role chairing Nigeria’s Civil Society Coalition’s Primary Health Care Revitalization Support Group to the 8th National Assembly, which successfully advocated for the Basic Health Care Provision Fund, I know that achieving universal health coverage will not rest upon one single static action, but on the spectrum of interventions and initiatives; from water, sanitation and hygiene standards in healthcare facilities to breastfeeding education and training for healthcare workers.

In a country as large as Nigeria, resilience throughout the whole nation’s system was always going to be necessary if we were going to be able to tackle critical health emergencies in fragile settings, such as in the North East. Today, even the strongest regions are sorely tested, and that is why a strengthened primary health care system is imperative as the foundation to achieve health for all. Support for PHCs should be a focal point for investment, as we coordinate our responses to the pandemic.

It is only by strengthening capacity and concrete frameworks at primary levels of care and education services that we can build the resilience to cope in times of crisis, restore health and prosperity, create healthy futures and improve the wellbeing of citizens in the long-term.

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